Keto Blues: Why Do I Feel So Bad?

The ketogenic (keto) diet is a popular choice for people looking to lose weight. The diet recommends eating protein, high-fat, and low (or no) carbohydrates. However, many people experience flu-like symptoms, often referred to as the keto flu, when starting this diet. The keto flu includes symptoms such as nausea, constipation, headaches, fatigue, and sugar cravings, which can range from mild to severe and can last from a few days to several weeks. This is due to the body's withdrawal from carbohydrates, the body's preferred energy source, and the transition to burning fat for energy, known as ketosis. While the keto diet may lead to weight loss, it is important to consider the potential side effects and make a balanced decision about your dietary choices.

Carb withdrawal

Carbohydrates are the body's preferred energy source. When you start a low-carb diet, such as keto, your body has to get used to relying on fat for energy instead. This transition can be challenging, and you may experience what is known as "carb withdrawal" or the "keto flu".

The first few days of a low-carb diet can be the most difficult. You may experience cravings for carbs and even a period of discomfort. It is quite normal to miss your favourite high-carb foods and find yourself thinking about them often. This is likely due to a strong psychological component.

During this initial withdrawal phase, it is important to focus on consuming enough fibre and fat. Eating fat and fibre together produces a high degree of satiety, or the feeling of being full. For example, foods made with flax seeds are high in both fibre and healthy omega-3 fatty acids. Salads with protein (tuna, chicken, etc.) and healthy low-carb dressing are another option.

Additionally, it is crucial to stay hydrated during this time. Drinking plenty of water can help with digestion and may also decrease feelings of hunger.

After the first few days of a low-carb diet, you may experience a "low-carb crash" or a more intense form of the keto flu. This occurs when your body's glucose reserves are depleted, but your body has not yet adjusted to getting energy from fat. Symptoms of a low-carb crash can include feeling shaky or jittery and a general sense of being "off".

To alleviate these symptoms, you can add a few high-quality carbs back into your diet. However, this should be minimal, as overloading on carbs would defeat the purpose of a low-carb diet. You can also try drinking a cup of bouillon or bone broth several times a day, as well as ensuring you are getting enough potassium.

The good news is that these uncomfortable symptoms are usually temporary. They typically last a few days to a few weeks, and by the end of the first week, you may start to feel increased energy and improved mental concentration.

If you are experiencing severe or prolonged symptoms, it is recommended to consult your doctor. Additionally, a low-carb diet may not be suitable for everyone, so it is important to speak to a healthcare professional before starting any new diet.

Dehydration

The keto diet is a popular choice for people looking to lose weight. It involves eating high-fat, low-carbohydrate foods, which puts the body into a metabolic state called ketosis, where it burns fat instead of sugar for fuel. While this diet is considered safe and can be part of a healthy lifestyle, it can also cause dehydration, especially when first starting out. Here's what you need to know about dehydration on the keto diet:

Why Keto Dieters Are Prone to Dehydration

The keto diet removes sodium from everyday eating habits. Sodium helps the body retain water, maintain electrolyte balance, and prevent mild dehydration. When you reduce your sodium intake, your body's ability to retain water is diminished, and you may become dehydrated more easily, especially if you are physically active or live in a warm climate.

Additionally, not all natural sources of electrolytes are keto-friendly, so deficiencies can occur. Electrolytes are essential for helping your body absorb and utilise water. Without enough electrolytes, your body won't be able to make the most of the water you're drinking, and dehydration may result.

Signs and Effects of Dehydration

• Muscle weakness or cramps
• Rapid heartbeat
• Fatigue
• Nausea
• Irritability
• Lethargy
• Dizziness
• Confusion or brain fog
• Dry mouth and throat
• Headaches
• Increased thirst and hunger

If left untreated, dehydration can lead to more serious health issues such as kidney stones, urinary tract infections, kidney damage, and increased blood pressure.

Preventing and Treating Dehydration on Keto

To prevent dehydration on the keto diet, it is recommended to:

• Drink plenty of water throughout the day. Aim for 2-3 litres or half your body weight in ounces.
• Start your day with a glass of water and keep a full glass nearby to remind you to drink.
• Use a tracking app or bottle to monitor your water intake.
• Include other hydrating liquids such as low-sugar broths, juices, and sports drinks.
• Eat water-rich and electrolyte-rich whole foods like leafy greens, avocados, cucumbers, berries, nuts, and seeds.
• Avoid dehydrating substances like alcohol and caffeine.
• Limit processed foods, which are high in sodium and low in potassium, leading to electrolyte imbalances.

If you are experiencing dehydration, focus on rehydrating with fluids and electrolytes. You can also try electrolyte supplements or sports drinks to help replenish your body's electrolyte levels.

Lack of sleep

The keto diet can cause interrupted sleep and insomnia in the short term, particularly in the early stages of transitioning to the diet. However, in the long term, the keto diet can lead to deeper sleep and less sleep overall.

• Gradually reduce carbohydrates: Instead of cutting out carbs completely, try eliminating one type of high-carb food at a time, such as grains, and then move on to sugary desserts, starchy vegetables, and fruits.
• Consume carbohydrates later in the day: Eating carbs before bed can help with sleep since they increase brain tryptophan, which is metabolized into serotonin and then melatonin, the sleep hormone.
• Get enough electrolytes: Electrolyte imbalances can be caused by low insulin levels on a keto diet. Eating a variety of electrolyte-rich foods, such as broccoli, watermelon, chicken, canned tuna, and strawberries, can help prevent these imbalances.
• Eat keto-friendly foods that promote better sleep: Include foods rich in magnesium, tryptophan, vitamin D, and omega-3 fatty acids, such as almonds, spinach, chicken, turkey, beef liver, and salmon.
• Follow a consistent sleep schedule: Decide on a specific bedtime and wake-up time and stick to it, aiming for 7-9 hours of sleep each night.
• Exercise regularly but avoid doing it close to bedtime: Exercise can help relieve insomnia, but for some people, nighttime exercise, especially high-intensity workouts, can interfere with sleep. Try to stop exercising at least 4 hours before bedtime.
• Practice relaxation techniques: Wind down before bed with a relaxing routine, such as reading a book or listening to soft music.
• Avoid caffeine close to bedtime: Cut back on coffee and avoid drinking it 6 hours before bed, as caffeine increases wakefulness and brain activity.
• Avoid using electronics at night: The blue light emitted by electronic devices suppresses melatonin, so turn off all electronic devices at least 2 hours before bed.

Electrolyte imbalance

When you start a keto diet, you can become deficient in electrolytes due to carb restriction, which leads to lower insulin levels. Insulin is an important hormone that helps the body absorb glucose from the bloodstream. When insulin levels decrease, the kidneys release excess sodium from the body. This is why it's important to replace lost fluids when you're on the keto diet. However, if you replace fluids too aggressively, you can dilute blood sodium levels, which can result in brain fog, headaches, and cramps.

The keto diet is also typically lower in certain electrolytes, such as sodium, potassium, magnesium, and calcium. For example, whole foods contain scant sodium, and many potassium-rich foods—such as fruits, potatoes, and starchy root vegetables—are too high in carbs for the keto diet.

This electrolyte imbalance is often linked to symptoms of "keto flu," which can include:

• Headaches
• Fatigue
• Weakness
• Dizziness
• Brain fog
• Muscle cramps
• Insomnia
• Irritability
• Diarrhea
• Constipation
• Thirst
• Increased cravings

If you're experiencing these symptoms, it's important to address the deficiency by tracking your electrolyte intake and making sure you're getting enough of these key minerals. You can do this by eating more electrolyte-rich foods, drinking electrolyte-infused water, or taking supplements.

Constipation

The keto diet involves drastically cutting back on carbohydrates and increasing fat and protein intake. Carbohydrates like fruits and whole grains are some of the most common sources of fibre, so removing them from your diet can lead to digestive issues like constipation. In addition, the keto diet restricts many foods that are high in potassium, including beans and starchy vegetables, which can further contribute to constipation.

Dairy is a common feature of the keto diet, as it is a good source of fat and protein. However, due to its lactose content, dairy can be hard to digest and lead to constipation.

Reduced water intake can also be a factor in keto-related constipation. With fewer fruits and vegetables in your diet, your water intake may decrease without you realizing it. In addition, a sudden drop in carb intake can lead to dehydration and an imbalance of electrolytes.

To treat and prevent constipation while on the keto diet, it is recommended to:

• Increase your water intake
• Add more dietary fibre, such as non-starchy vegetables, berries, avocados, and nuts
• Cut back on dairy
• Exercise regularly
• Introduce the keto diet gradually, rather than all at once
• Avoid simple carbohydrates, processed foods, and fast food

Frequently asked questions